WO2012163363A1 - Evaluation de la qualité des embryons basée sur le clivage des blastomères et morphologie - Google Patents

Evaluation de la qualité des embryons basée sur le clivage des blastomères et morphologie Download PDF

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WO2012163363A1
WO2012163363A1 PCT/DK2012/050188 DK2012050188W WO2012163363A1 WO 2012163363 A1 WO2012163363 A1 WO 2012163363A1 DK 2012050188 W DK2012050188 W DK 2012050188W WO 2012163363 A1 WO2012163363 A1 WO 2012163363A1
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embryo
hours
quality
less
criterion
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PCT/DK2012/050188
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English (en)
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Niels B Ramsing
Karen Marie HILLIGSØE
Marcos Meseguer ESCRIVÁ
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Unisense Fertilitech A/S
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Priority to EP12728169.9A priority Critical patent/EP2714895B1/fr
Priority to CN201280035768.1A priority patent/CN103748216B/zh
Priority to US14/122,335 priority patent/US20140087415A1/en
Publication of WO2012163363A1 publication Critical patent/WO2012163363A1/fr
Priority to IN9921DEN2014 priority patent/IN2014DN09921A/en
Priority to CN201380040406.6A priority patent/CN104508123B/zh
Priority to US14/403,847 priority patent/US20150147770A1/en
Priority to AU2013269608A priority patent/AU2013269608B2/en
Priority to PCT/EP2013/061260 priority patent/WO2013178785A1/fr
Priority to EP13729621.6A priority patent/EP2855664B1/fr

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06V—IMAGE OR VIDEO RECOGNITION OR UNDERSTANDING
    • G06V20/00—Scenes; Scene-specific elements
    • G06V20/60—Type of objects
    • G06V20/69—Microscopic objects, e.g. biological cells or cellular parts
    • G06V20/695—Preprocessing, e.g. image segmentation
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/5005—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/0002—Inspection of images, e.g. flaw detection
    • G06T7/0012—Biomedical image inspection
    • G06T7/0014—Biomedical image inspection using an image reference approach
    • G06T7/0016—Biomedical image inspection using an image reference approach involving temporal comparison
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10016—Video; Image sequence
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10056—Microscopic image
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/20—Special algorithmic details
    • G06T2207/20212—Image combination
    • G06T2207/20224—Image subtraction
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30044—Fetus; Embryo

Definitions

  • the present invention relates to a method and to a system for selecting embryos for in vitro fertilization based on the timing, and duration of observed cell cleavages and associated cell morphology.
  • Infertility affects more than 80 million people worldwide. It is estimated that 10% of all couples experience primary or secondary infertility (Vayena et al. 2001).
  • In vitro fertilization (IVF) is an elective medical treatment that may provide a couple who has been otherwise unable to conceive a chance to establish a pregnancy. It is a process in which eggs (oocytes) are taken from a woman's ovaries and then fertilized with sperm in the laboratory. The embryos created in this process are then placed into the uterus for potential implantation. To avoid multiple pregnancies and multiple births, only a few embryos are transferred (normally less than four and ideally only one (Bhattacharya et al. 2004)).
  • One approach is to use 'early cleavage' to the 2-cell stage, (i.e. before 25 - 27 h post insemination/injection), as a quality indicator.
  • the embryos are visually inspected 25 - 27 hours after fertilization to determine if the first cell cleavage has been completed.
  • the early cleavage as well as other early criteria may be a quality indicator for development into an embryo there is still a need for quality indicators for implantation success and thereby success for having a baby as a result.
  • the present invention relates to a method and to a system to facilitate the selection of optimal embryos to be transferred for implantation after in vitro fertilization (IVF) based on the timing, and duration of observed cell cleavages.
  • IVF in vitro fertilization
  • the invention in a first aspect relates to a method for determining embryo quality comprising monitoring the embryo for a time period, and determining one or more quality criteria for said embryo, and based on said one or more quality criteria determining the embryo quality.
  • the invention may be applied to human embryos and the obtained embryo quality measure may be used for identifying and selecting embryos suitable of transplantation into the uterus of a female in order to provide a pregnancy and live-born baby.
  • the invention relates to a method for determining embryo quality comprising monitoring the embryo for a time period, and determining one or more quality criteria for said embryo, wherein said one or more quality criteria is based on the extent of irregularity of the timing of cell divisions when the embryo develops from four to eight blastomeres, and/or wherein said one or more quality criteria is based on determining the time of cleavage to a five blastomere embryo (t5) and wherein t5 is between 48.7 hours and 55.6 hours, and/or wherein said one or more quality criteria is based on the ratio of two time intervals, each of said two time intervals determined as the duration of a time period between two morphological events in the embryo development from fertilization to eight blastomeres, and based on said one or more quality criteria determining the embryo quality.
  • the invention relates to a method for selecting an embryo suitable for transplantation, said method comprising monitoring the embryo as defined above obtaining an embryo quality measure, and selecting the embryo having the highest embryo quality measure.
  • the invention relates to a system having means for carrying out the methods described above.
  • Said system may be any suitable system, such as a computer comprising computer code portions constituting means for executing the methods as described above.
  • the system may further comprise means for acquiring images of the embryo at different time intervals, such as the system described in pending PCT application entitled “Determination of a change in a cell population", filed Oct 16 2006.
  • the invention relates to a data carrier comprising computer code portions constituting means for executing the methods as described above.
  • Fig. 1 Nomenclature for the cleavage pattern showing cleavage times (t2-t5), duration of cell cycles (cc1-cc3), and synchronies (s1-s3) in relation to images obtained.
  • Fig. 2 Hierarchical decision tree with the parameters t5-s2-cc2
  • Fig. 3 Schematic hierarchical decision tree with the parameters t5-s2-cc2 based on: i) Morphological screening; ii) absence of exclusion criteria; iii) timing of cell division to five cells (t5); iv) synchrony of divisions from 2-cell to 4-cell stage, s2, i.e. duration of 3- cell stage; v) duration of second cell cycle, cc2, i.e. time between division to 3-cell stage and division to 5-cell stage.
  • the classification generates ten grades of embryos with increasing expected implantation potential (right to left) and almost equal number of embryos in each.
  • Fig.5. A series of images showing direct cleavage to 3 blastomere embryo. Cleavage from 1 to 3 cells happens in one frame Fig. 6a Uneven blastomere size at the 2 cell stage (2 cell cycle) - Fig. 6b Even blastomere size at the 2 cell stage
  • Fig. 8 Percentage of embryos having completed a cell division by a given time after fertilization. Blue curves present implanting embryos, red curves represent embryos that do not implant. Four curves of each color represent completion of the four consecutive cell divisions from one to five cells i.e. t2, t3, t4, and t5.
  • Fig. 9 Distribution of the timing for cell division to five cells, t5, for 61 implanting embryos (positive, blue dots) and for 186 non-implanting embryos (negative, red dots).
  • the left panel show the overall distributions of cleavage times. Short blue lines demarcate standard deviations, means and 95% confidence limits for the mean. Red boxes denote the quartiles for each class of embryos.
  • Fig. 10 Percentage of implanting embryos with cell division times inside or outside ranges defined by quartile limits for the total dataset.
  • the three panels show ranges and implantation for: i) division to 2-cells, t2; ii) division to 3-cells, t3; and division to 5- cells, t5.
  • limits for the ranges were defined as quartiles, each column represent the same number of transferred embryos with known implantation outcome, but the frequency of implantation was significantly higher for embryos within the rages as opposed to those outside the ranges.
  • Fig. 11 Percentage of implanting embryos with cell division parameters below or above the median values. The two panels show classification for: i) duration of second cell cycle, cc2; ii) synchrony of divisions from 2-cell to 4-cell stage, s2. As the limits are defined as median values for all 247 investigated embryos with known implantation outcome, each column represent the same number of transferred embryos and the frequency of implantation was significantly higher for embryos with parameter values below the median.
  • Fig. 12. Implantation rate in high and low implantation groups for the parameters t2, t3, t4, t5, cc2, cc3, and s2.
  • Fig. 13 Implantation rate in high and low implantation groups for the parameters t2, t3, t4, t5, cc2, cc3, and s2.
  • Known Implantation data (see example 2) divided into quartiles with respect to t2 and with the expected value for each quartile (left graph). From these quartile groups a new target group is formed by the three neighboring quartiles Q1 , Q2 and Q3 having similar probabilities (right graph) - see example 2.
  • Fig. 15 Decision tree model built using quality and exclusion criteria from t2 and forward.
  • Fig. 16 Decision tree model built using quality and exclusion criteria from t4 and forward (i.e. only late phase criteria).
  • Cleavage time is defined as the first observed timepoint when the newly formed blastomeres are completely separated by confluent cell membranes, the cleavage time is therefore the time of completion of a blastomere cleavage. In the present context the times are expressed as hours post IntraCytoplasmic Sperm Injection (ICSI)
  • microinjection i.e. the time of fertilization.
  • cleavage times are as follows:
  • ⁇ t4 Time of cleavage to 4 blastomere embryo
  • ⁇ s3 t8-t5: Synchrony in division from 4 blastomere embryo to 8 blastomere embryo.
  • Cleavage period The period of time from the first observation of indentations in the cell membrane (indicating onset of cytoplasmic cleavage) to the cytoplasmic cell cleavage is complete so that the blastomeres are completely separated by confluent cell membranes. Also termed as duration of cytokinesis. Fertilization and cleavage are the primary morphological events of an embryo, at least until the 8 blastomere stage.
  • Cleavage time, cell cycle, synchrony of division and cleavage period are examples of morphological embryo parameters that can be defined from these primary morphological events and each of these morphological embryo parameters are defined as the duration of a time period between two morphological events, e.g. measured in hours.
  • a normalized morphological embryo parameter is defined as the ratio of two
  • cc2 divided by cc3 (cc2/cc3), or cc2/cc2_3 or cc3/t5 or s2/cc2.
  • cc2/cc3 cc2/cc3
  • cc3/t5 cc3/t5 or s2/cc2.
  • MN2 Multi nucleation observed at the 2 blastomere stage; can take the values "True” or False”.
  • MN4 Multi nucleation observed at the 4 blastomere stage; can take the values "True” or False”.
  • Cellular movement Movement of the center of the cell and the outer cell membrane. Internal movement of organelles within the cell is NOT cellular movement. The outer cell membrane is a dynamic structure, so the cell boundary will continually change position slightly. However, these slight fluctuations are not considered cellular movement. Cellular movement is when the center of gravity for the cell and its position with respect to other cells change as well as when cells divide. Cellular movement can be quantified by calculating the difference between two consecutive digital images of the moving cell. An example of such quantification is described in detail in the pending PCT application entitled "Determination of a change in a cell population", filed Oct 16 2006. However, other methods to determine movement of the cellular center of gravity, and/or position of the cytoplasm membrane may be envisioned e.g. by using
  • FertiMorph software (ImageHouse Medical, Copenhagen, Denmark) to semi- automatically outline the boundary of each blastomere in consecutive optical transects through an embryo.
  • Organelle movement Movement of internal organelles and organelle membranes within the embryo which may be visible by microscopy. Organelle movement is not Cellular movement in the context of this application.
  • Movement spatial rearrangement of objects. Movements are characterized and/or quantified and/or described by many different parameters including but restricted to: extent of movement, area and/or volume involved in movement, rotation, translation vectors, orientation of movement, speed of movement, resizing, inflation/deflation etc. Different measurements of cellular or organelle movement may thus be used for different purposes some of these reflect the extent or magnitude of movement, some the spatial distribution of moving objects, some the trajectories or volumes being afflicted by the movement.
  • Embryo quality is a measure of the ability of said embryo to successfully implant and develop in the uterus after transfer. Embryos of high quality will successfully implant and develop in the uterus after transfer whereas low quality embryos will not.
  • Embryo viability is a measure of the ability of said embryo to successfully implant and develop in the uterus after transfer. Embryos of high viability will successfully implant and develop in the uterus after transfer whereas low viability embryos will not.
  • Embryo quality (or viability) measurement is a parameter intended to reflect the quality (or viability) of an embryo such that embryos with high values of the quality parameter have a high probability of being of high quality (or viability), and low probability of being low quality (or viability). Whereas embryos with an associated low value for the quality (or viability) parameter only have a low probability of having a high quality (or viability) and a high probability of being low quality (or viability)
  • implantation as the endpoint, not only embryo competence for blastocyst formation, but also subsequent highly essential processes such as hatching and successful implantation in the uterus is assessed.
  • the data allows the detection of later developmental criteria for implantation potential.
  • the results in particular indicate that timing of later events such as the cleavage to the five cell stage are a consistently good indicator of implantation potential, and that the discrimination between implanting and non-implanting embryos is improved when using the later cell division events, e.g. t5 as opposed to the earlier events (t2, t3 and t4).
  • the presented data indicate that incubating the embryos to day 3, which enables evaluation of timing for cell divisions from five to eight cells, after completion of the third cell cycle, can give additional important information that will improve the ability to select a viable embryo with high implantation potential.
  • the invention relates to a method for determining embryo quality comprising monitoring the embryo for a time period, and determining one or more quality criteria for said embryo, and based on said quality criteria determining the embryo quality.
  • the embryo quality is a quality relating to implantation success.
  • the selection criteria can be based on single variables, composite variables (variables that can be calculated from other variables) and multiple variables (more variables at once).
  • the quality criteria used herein are preferably criteria relating to the phase from a 2 to 8 blastomere embryo, in particularly from 4 to 8 blastomere embryo, and accordingly, the present quality criteria may be determination of the time for cleavage into a 5 blastomere embryo, 6 blastomere embryo, 7 blastomere embryo, and/or 8 blastomere embryo.
  • the present quality criteria is a preferably criteria obtained within the time period of from 48 to 72 hours from fertilisation.
  • the clock starts at the time of fertilisation which in the present context is meant to be the time of injection of the sperm, such as by ICSI microinjection.
  • the embryo is monitored for a time period comprising at least three cell cycles, such as at least four cell cycles.
  • the time for cleavage into a 5 blastomere embryo has an important impact on the implantation success, and therefore the quality criteria is preferably determination of the time for cleavage into a 5 blastomere embryo, i.e. t5.
  • t5 should preferably be in the range of from 47-58 hours from fertilisation, more preferably in the range of 48-57 hours from fertilisation, more preferably in the range of 48.7 - 55.6 hours from fertilisation.
  • the time for cleavage into a 2 blastomere embryo has an important impact on the implantation success and t2 should preferably be less than 32 hours from fertilisation, more preferably less than 27.9 hours from fertilisation. In a further embodiment of the invention t2 ⁇ 24.3 hours.
  • the time for cleavage into a 3 blastomere embryo may have an impact on the implantation success and t3 should preferably be less than or equal to 40.3 hours from fertilisation. In a further embodiment of the invention t3 ⁇ 35.4 hours.
  • the time for cleavage into a 6 blastomere embryo may have an impact on the implantation success and t6 should preferably be less than 60 hours from fertilisation.
  • the time for cleavage into a 7 blastomere embryo may have an impact on the implantation success and t7 should preferably be less than 60 hours from fertilisation.
  • the time for cleavage into an 8 blastomere embryo may have an impact on the implantation success and t8 should preferably be less than 60 hours from fertilisation more preferably less than 57.2 hours from fertilisation.
  • s2 t4-t3
  • s2 should preferably be less than 1.33 hours or less than 0.33 hours.
  • s3 t8-t5
  • s3 should preferably be less than 2.7 hours.
  • variables may be used when choosing selection criteria.
  • the variables are selected progressively such that initially one or more of the variables that can be determined early with a high accuracy are chosen, e.g. t2, t3, t4 or t5. Later other variables that can be more difficult to determine and is associated with a higher uncertainty can be used (e.g. multinuclearity, evenness of cells and later timings (e.g. after t5)).
  • the present quality criteria is combined with determination of second cell cycle length in order to establish the embryo quality. In another embodiment the present quality criteria is combined with determination of synchrony in cleavage from 2 blastomere embryo to 4 blastomere embryo.
  • the embryo quality is determined from a combination of determination of time for cleavage to a 5 blastomere embryo and determination of the second cell cycle length.
  • an embryo quality criterion is selected from the group of normalized morphological embryo parameters, in particular the group of normalized morphological parameters based on two, three, four, five or more parameters selected from the group of t2, t3, t4, t5, t6, t7 and t8.
  • the time of fertilization may be "removed" from the embryo quality assessment.
  • a normalized morphological embryo parameter may better describe the uniformity and/or regularity of the developmental rate of a specific embryo independent of the environmental conditions, because instead of comparing to
  • the use of normalized parameters ensure that specific ratios of time intervals can be compared to "globally" determined normalized parameters, thereby providing additional information of the embryo development.
  • the ratio cc2/cc3 may indicate whether the duration of cell cycle 2 corresponds (relatively) to the duration of cell cycle 3
  • cc2/cc2_3 provides the duration of the period as a 2 blastomere embryo relative to the duration of the period as a 2, 3 and 4 blastomere embryo
  • s2/cc2 provides the synchronicity from 2 to 4 blastomere relative to the duration of the period as a 2 blastomere embryo
  • cc3/t5 provides the duration of cell cycle 3 relative to the time of cleavage to a 5 blastomere embryo.
  • the normalized morphological embryo parameter cc2/cc3 (t3-t2)/(t5-t3) should be between 0.72 and 0.88. Irregularity from 4 to 8 blastomeres
  • the timing of the individual cell divisions when the embryo develops from 4 to 8 blastomeres may be associated with embryo quality and success of implantation. These timings may demonstrate the competence of each individual cell to perform a cell division. Possible irregularities or abnormalities in the mitosis may result in large differences between the value of s3a, s3b and/or s3c.
  • an embryo quality criterion is the extent of the irregularity of the timing of cell divisions, such as irregularity of the timing of cell divisions until the 8 blastomere embryo, such as irregularity of the timing of cell divisions when developing from 4 to 8 blastomere embryo.
  • an embryo quality criterion is the maximum of s3a, s3b and s3c.
  • the maximum of s3a, s3b and s3c is less than 1.5 hours.
  • an embryo quality criterion is the maximum of s3a, s3b and s3c divided by s3, preferably max(s3a, s3b, s3c)/s3 is less than 0.5.
  • max(s3a, s3b, s3c)/s3 is a normalized morphological embryo parameter based on t5, t6, t7 and t8.
  • Multi nucleation may be an embryo quality parameter, in particular multi nucleation observed at the 4 blastomere stage (MN4).
  • MN4 multi nucleation observed at the 4 blastomere stage
  • MN4 False.
  • EV2 Evenness of the blastomeres in the 2 blastomere embryo; can take the values "True” (i.e. even) or "False” (i.e. uneven).
  • An embryo population may be subject to one or more exclusion criteria in order to exclude embryos from the population with a low probability of implantation success, i.e. the outliers.
  • This may be embryos that fulfil many of the positive selection criteria but show unusual behaviour in just one or two selection criteria.
  • exclusion criteria are the discrete criteria such as blastomere evenness at t2 and multi nuclearity at the four-blastomere stage.
  • exclusion criteria may also be applied to the morphological embryo parameters. It has long been known that slowly developing embryos are an indication of poor quality, reflected in a very high value of t2 (>31.8 hours), but cleavage from one blastomere directly to three blastomeres may also be an indication of a poor quality embryo associated with low implantation rate. This may be reflected in very low values for cc2 and cc3.
  • a specific exclusion criterion pointing out a group of embryos in a population with a low probability of implantation does not imply that the rest of the population has a high probability of implantation.
  • An exclusion criterion only indicates poor quality embryos.
  • said one or more quality criteria are combined with one or more exclusion criteria.
  • An example of applying exclusion criteria to a population of embryos is shown in fig. 17. cc2 (hours) is along the x-axis whereas cc3 (hours) is along the y-axis.
  • Embryos that successfully implanted are depicted as triangles whereas non-successful embryos (embryos that did not successfully implant) are depicted as circles. It is seen that a large group of non-successful embryos with low cc2 assemble to the left in the figure and a large group of non-successful embryos with low cc3 assemble in the bottom of the figure. If exclusion criteria of cc2 less than 5 hours and/or cc3 less than 5 hours are applied, large groups of non-successful embryos can be excluded thereby helping to isolate the successful embryos, from where better quality criteria can be extracted.
  • the embryo is monitored regularly to obtain the relevant information, preferably at least once per hour, such as at least twice per hour, such as at least three times per hour.
  • the monitoring is preferably conducted while the embryo is situated in the incubator used for culturing the embryo. This is preferably carried out through image acquisition of the embryo, such as discussed below in relation to time-lapse methods.
  • Determination of selection criteria's can be done for example by visual inspection of the images of the embryo and/or by automated methods such as described in detail in the pending PCT application entitled “Determination of a change in a cell population” filed Oct 16 2006. Furthermore, other methods to determine selection criteria's can be done by determining the position of the cytoplasm membrane by envisioned e.g. by using FertiMorph software (ImageHouse Medicall Copenhagen, Denmark). The described methods can be used alone or in combination with visual inspection of the images of the embryo and/or with automated methods as described above. Decision tree model
  • the criteria may be combined in a hierarchical form, as shown in Figs. 2 and 3, see also example 1 for more information thereby giving rise to a decision tree model (or classification tree model) to select embryos with higher implantation probabilities.
  • a classification tree model several variables are used to split the embryos into groups with different associated probability of implantation success rate by using successive splitting rules.
  • the classification tree model can be optimized under a set of given constraints selecting the optimal variables to use in the splitting rules from a set of possible variables.
  • the variables used in the model can e.g. be morphological embryo parameters based on time intervals between morphological events and the corresponding normalized morphological embryo parameters and discrete variables (e.g. multi nuclearity or evenness of blastomeres), or any
  • AUC area under the ROC curve
  • the decision tree depicted in Fig. 3 represents a sequential application of the identified selection criteria in combination with traditional morphological evaluation.
  • the decision tree subdivided embryos into 6 categories from A to F. Four of these categories (A to D) were further subdivided into two sub-categories (+) or (-) as shown in Figure 5, giving a total of 10 categories.
  • the hierarchical decision procedure start with a morphological screening of all embryos in a cohort to eliminate those embryos that are clearly NOT viable (i.e. highly abnormal, attretic or clearly arrested embryos).
  • Next step in the model is to exclude embryos that fulfil any of the three exclusion criteria: i) uneven blastomere size at the 2 cell stage, ii) abrupt division from one to three or more cells; or iii) multi-nucleation at the four cell stage (category E).
  • the subsequent levels in the model follow a strict hierarchy based on the binary timing variables t5, s2 and cc2. First, if the value of t5 falls inside the optimal range the embryo is categorized as A or B. If the value of t5 falls outside the optimal range (or if t5 has not yet been observed at 64 hours) the embryo is categorized as C or D.
  • the embryo is categorized as A or C depending on t5 and similarly if the value of s2 falls outside the optimal range the embryo is categorized as B or D depending on t5. Finally, the embryo is categorized with the extra plus (+) if the value for cc2 is inside the optimal range ( ⁇ 11.9 hrs) (A+/B+/C+/D+) and is categorized as A,B,C,D if the value for cc2 is outside the optimal range.
  • the decision procedure divides all the 247 evaluated embryos in ten different categories containing approx. the same number of transferred embryos but with largely decreasing implantation potential (i.e. from 68% for A+ to 8% for E).
  • this dataset provides a unique opportunity to test the quality and exclusion criteria presented herein in order to optimize the classification of IVF embryos.
  • classify in terms of quality
  • a transfer must be performed and a classification of the embryos is therefore important to select the best of embryos.
  • the quality criteria discussed above may also be combined with determinations of movement of the embryo, such as i) determining the extent and/or spatial distribution of cellular or organelle movement during the cell cleavage period; and/or ii) determining the extent and/or spatial distribution of cellular or organelle movement during the inter- cleavage period thereby obtaining an embryo quality measure.
  • the cell positions are usually relatively stationary between cell cleavages (i.e. little cellular movement), except for a short time interval around each cell cleavage, where the cleavage of one cell into two leads to brief but considerable rearrangement of the dividing cells as well as the surrounding cells (i.e. pronounced cellular movement).
  • the lesser movement between cleavages is preferred.
  • the length of each cleavage period may be determined as well as the length of each inter-cleavage period.
  • the period of cellular movement in at least two inter-cleavage periods is determined as well as the extent of cellular movement in at least two inter-cleavage periods. Furthermore, it has been found that rapid cleavage seems to increase quality of the embryo, where rapid normally means less than 2 hours.
  • a neural network or other quantitative pattern recognition algorithms may be used to evaluate the complex cell motility patterns described above, for example using different mathematical models (linear, Princepal component analysis, Markov models etc.)
  • Time-lapse monitoring A particular use of the invention is to evaluate image series of developing embryos (time-lapse images). These time-lapse images may be analyzed by difference imaging equipment (see for example WO 2007/042044 entitled “Determination of a change in a cell population”). The resulting difference images can be used to quantify the amount of change occurring between consecutive frames in an image series.
  • the invention may be applied to analysis of difference image data, where the changing positions of the cell boundaries (i.e. cell membranes) as a consequence of cellular movement causes a range parameters derived from the difference image to rise temporarily (see WO 2007/042044). These parameters include (but are not restricted to) a rise in the mean absolute intensity or variance. Cell cleavages and their duration and related cellular re-arrangement can thus be detected by temporary change, an increase or a decrease, in standard deviation for all pixels in the difference image or any other of the derived parameters for "blastomere activity" listed in WO 2007/042044.
  • the selection criteria may also be applied to visual observations and analysis of time-lapse images and other temporally resolved data (e.g.
  • the present invention demonstrates that routine time-lapse monitoring of embryo development in a clinical setting (i.e. automatic image acquisition in an undisturbed controlled incubation environment) provide novel information about developmental parameters that differ between implanting and non-implanting embryos.
  • embryo In some cases the term "embryo" is used to describe a fertilized oocyte after implantation in the uterus until 8 weeks after fertilization at which stage it becomes a foetus. According to this definition the fertilized oocyte is often called a pre-embryo until implantation occurs. However, throughout this patent application we will use a broader definition of the term embryo, which includes the pre-embryo phase. It thus
  • An embryo is approximately spherical and is composed of one or more cells
  • the zona pellucida performs a variety of functions until the embryo hatches, and is a good landmark for embryo evaluation.
  • the zona pellucida is spherical and translucent, and should be clearly distinguishable from cellular debris.
  • An embryo is formed when an oocyte is fertilized by fusion or injection of a sperm cell (spermatozoa).
  • spermatozoa a sperm cell
  • the term is traditionally used also after hatching (i.e. rupture of zona pelucida) and the ensuing implantation.
  • the fertilized oocyte is traditionally called an embryo for the first 8 weeks. After that (i.e. after eight weeks and when all major organs have been formed) it is called a foetus. However the distinction between embryo and foetus is not generally well defined.
  • embryo is used in the following to denote each of the stages fertilized oocyte, zygote, 2-cell, 4-cell, 8-cell, 16-cell, morula, blastocyst, expanded blastocyst and hatched blastocyst, as well as all stages in between (e.g. 3 -cell or 5- cell)
  • a final analysis step could include a comparison of the made observations with similar observations of embryos of different quality and development competence, as well as comparing parameter values for a given embryo with other quantitative measurements made on the same embryo. This may include a comparison with online measurements such as blastomere motility, respiration rate, amino acid uptake etc.
  • a combined dataset of blastomere motility analysis, respiration rates and other quantitative parameters are likely to improve embryo selection and reliably enable embryologist to choose the best embryos for transfer.
  • the method according to the invention may be combined with other measurements in order to evaluate the embryo in question, and may be used for selection of competent embryos for transfer to the recipient.
  • Such other measurements may be selected from the group of respiration rate, amino acid uptake, motility analysis, blastomere motility, morphology, blastomere size, blastomere granulation, fragmentation, blastomere colour, polar body orientation, nucleation, spindle formation and integrity, and numerous other qualitative
  • the respiration measurement may be conducted as described in PCT publication no. WO 2004/056265.
  • the observations are conducted during cultivation of the cell population, such as wherein the cell population is positioned in a culture medium.
  • Means for culturing cell population are known in the art. An example of culturing an embryo is described in PCT publication no. WO 2004/056265.
  • Data carrier The invention further relates to a data carrier comprising a computer program directly loadable in the memory of a digital processing device and comprising computer code portions constituting means for executing the method of the invention as described above.
  • the data carrier may be a magnetic or optical disk or in the shape of an electronic card as for example the type EEPROM or Flash, and designed to be loaded into existing digital processing means. Selection or identification of embryos
  • the present invention further provides a method for selecting an embryo for transplantation.
  • the method implies that the embryo has been monitored as discussed above to determine when cell cleavages have occurred.
  • the selection or identifying method may be combined with other measurements as described above in order to evaluate the quality of the embryo.
  • the important criteria in a morphological evaluation of embryos are: (1) shape of the embryo including number of blastomers and degree of fragmentation; (2) presence and quality of a zona pellu- cida; (3) size; (4) colour and texture; (5) knowledge of the age of the embryo in relation to its developmental stage, and (6) blastomere membrane integrity.
  • the transplantation may then be conducted by any suitable method known to the skilled person.
  • the research project was conducted at the Instituto Valenciano de Infertilidad— IVI, Valencia.
  • the procedure and protocol was approved by an Institutional Review Board, (IRB), which regulates and approves database analysis and clinical IVF procedures for research at IVI.
  • IVI Institutional Review Board
  • the project complies with the Spanish Law governing Assisted
  • ICSI Cytoplasmic Sperm Injection
  • the exclusion criteria for standard patients and recipients with respect to this study were: low response (less than 5 Mil oocytes), endometriosis, Polycystic Ovarian Syndrome (PCOS), hydrosalpynx, BMI > 30 kg/m 2 , uterine pathology (myomas, adenomyiosis, endocrinopaties, trombophylia, chronic pathologies, acquired or congenital uterine abnormalities), recurrent pregnancy loss, maternal age over 39 years old for standard patients and 45 for oocyte donation recipients (aging uterus), or severe masculine factor (presenting less than 5 million motile sperm cells in total in the ejaculate).
  • GnRH agonist protocols Prior to controlled ovarian stimulation (COS), cycles with GnRH agonist protocols were used.
  • GnRH agonist protocols patients started with administration of 0.5 mg leuprolide acetate (Procrin ®; Abbott, Madrid, Spain) in the midluteal phase of the previous cycle, until negative vaginal ultrasound defined ovarian quiescence. Patients with adequate pituitary desensitization started their stimulation, and the dose of GnRH- agonist was reduced to 0.25 mg per day until the day of hCG administration (Melo, M. 2009).
  • the serum E2 kit had a sensitivity of 28 pg/mL and intraobserver and interobserver variation coefficients of 6.6% and 7.7%, respectively.
  • Protocol for endometrial preparation of recipients can be found in (Meseguer, M. 2008; Meseguer, M. 2010). Briefly, patients with ovarian function were downregulated with a single dose of 3.75 mg of Triptorelin (Decapeptyl 3.75, Ipsen Pharma S.A., Madrid, Spain) administered IM in the secretory phase of the previous cycle. Hormonal replacement started on day 1 of the cycle after ovarian downregulation was confirmed with vaginal ultrasound. Patients started oral administration of 2 mg/day of E 2 valerate (Progynova, Schering Spain, Madrid, Spain) from days 1 to 8; 4 mg/day from days 9 to 1 1 ; and 6 mg/day from day 12 on. Patients without ovarian function started hormonal replacement directly.
  • vaginal ultrasound was performed and serum E 2 determined. If recipients were ready to receive oocytes, they waited having 6 mg/day of E 2 valerate until an adequate donation was available. After embryo transfer for luteal phase support all patients received a daily dose of 200 mg for standard patients and 400mg for oocyte recipients of vaginal micronized progesterone (Progeffik Effik, Madrid Spain) every 12 hours. Ovum pick-up and ICSI
  • QAFM Advantage Fertilization medium
  • QAFM Advantage Fertilization medium
  • ICSI ICSI was performed in a medium containing HEPES (QAM) (Garcia-Herrero.S. 2010). ICSI was performed at 400x magnification using an Olympus IX7 microscope. Finally the oocytes was placed in pre-equilibrated slides (EmbryoSlide® Unisense FertiliTech, Aarhus Denmark).
  • the slides are constructed with a central depression containing 12 straight-sided cylindrical wells each containing a culture media droplet of 20 ⁇ _ Quinn's Advantage Cleavage medium (QACM).
  • the depression containing the 12 wells was filled with an overlay of 1.4 ml_ mineral oil to prevent evaporation.
  • the slides were prepared at least 4 hrs in advance and left in an incubator to pre-equilibrate at 37 °C in the 5.0 % C02 atmosphere. After pre-equilibration all air bubbles are meticulously removed before the oocytes are placed individually in dropplets and incubated in the time-lapse monitoring system until embryo transfer 72 hour later approximately.
  • the time-lapse instrument, EmbryoScope®, (ES), Unisense FertiliTech, Aarhus, Denmark
  • ES Unisense FertiliTech, Aarhus, Denmark
  • oocyte/embryo incubator with a built in microscope to automatically acquire images of up to 72 individual embryos during development.
  • the imaging system in the ES uses low intensity red light (635 nm) from a single LED with short illumination times of 30 ms per image to minimize embryo exposure to light and to avoid damaging short wavelength light.
  • the optics comprise of a modified Hoffmann contrast with a 20x speciality objective (Leica Place) to provide optimal light sensitivity and resolution for the red wavelength.
  • the digital images are collected by a highly sensitive CCD camera (1280 x 1024 pixels) with a resolution of 3 pixels per ⁇ . Image stacks were acquired at 5 equidistant focal planes every 15 minutes during embryo development inside the ES (i.e. from about 1 hr after fertilization to transfer on day 3 about 72 hrs after fertilization).
  • Embryo exposure to light during incubation was measured with a scalar irradiance microsensor with a tip diameter of 100 ⁇ placed within the EmbryoScope at the position of the embryo in the EmbryoSlide. Similar measurements were made on standard microscopes used in fertility clinics. The total exposure time in the time-lapse system during 3 day culture and acquisition of 1420 images were 57 seconds, which compares favourably with the 167s microscope light exposure time reported for a standard IVF treatment (Ottosen et al, 2007).
  • the total light dose during 3 day incubation in the time-lapse system was found to be 20 J/m2 (i.e. 0.24 as opposed to an exposure of 394 J/m2 during microscopy in normal IVF treatments (i.e. 4.8 ⁇ J/embryd) based on average illumination times from (Ottosen et al, 2007) and measured average intensities with the scalar irradiance microsensor.
  • the spectral composition of the light in the ES was confined to a narrow range centred around 635 nm, and thus devoid of low wavelength light below 550 nm, and comprise about 15% of the light encountered in a normal IVF microscope. Embryo score and culture conditions
  • Embryo selection were performed exclusively by morphology based on: i) absence of multinucleated cells; ii) between 2-5 cells on day-2; iii) between 6 -10 cells on day 3; iv) total fragment volume of less than 15% of the embryo and; v) the embryo must appear symmetric with only slightly asymmetric blastomeres (Meseguer, M. 2006; Muriel, L. 2006; Meseguer, M. 2008). A total of 522 embryos were transferred to 285 patients.
  • EmbryoViewer ® workstation (EV), (Unisense FertiliTech, Aarhus , Denmark) using image analysis software in which all the considered embryo developmental events were annotated together with the corresponding timing of the events in hrs after ICSI microinjection. Subsequently the EV was used to identify the precise timing of the 1 st cell division. This division was the division to 2 cells and a shorthand notation of t2 is used in the following. Annotation of the 2 nd (i.e. to 3 cells, t3), 3 rd (4 cells, t4) and 4 th (5 cells, t5) cell division were done likewise. For the purpose of this study, time of cleavage was defined as the first observed timepoint when the newly formed blastomeres are completely separated by confluent cell membranes. All events are expressed as hours post ICSI microinjection.
  • EV EmbryoViewer ® workstation
  • the duration of the second cell cycle was defined as the time from division to a two blastomere embryo until division to a 3 blastomere embryo.
  • the number of embryos transferred was normally two, but in some cases 1 or 3 embryos were transferred because of embryo quality or patient wishes. Supernumerary embryos were frozen for potential future transfers using IVI standard vitrification technique (Cobo et al. 2008). The ⁇ -hCG value was determined 13 days after embryo transfer and the clinical pregnancy was confirmed when a gestational sac with foetal heartbeat was visible after 7 weeks of pregnancy.
  • timings were converted from continuous variables into a categorical variable using quartiles for all observations of each of the measured parameters.
  • timing quartiles By this procedure, bias due to differences in the total number of embryos in each category was avoided.
  • the percentage of embryos that implanted for each timing quartile was calculated to assess the distribution of implantation in the different categories.
  • the derived embryo timings were analyzed using Student's T-test when comparing two groups, and Analysis of Variance (ANOVA) followed by Bonferroni's and Scheffe's post hoc analysis when multiple groups were considered.
  • the odds ratio (OR) of the effect of all binary variables generated on implantation were expressed in terms of 95 % confidence interval (CI95) and significance.
  • CI95 % confidence interval
  • Significance was calculated using the omnibus test (likehood ratio), and the uncertainties uncovered by the model were evaluated by Negelkerke R 2 , a coefficient that is analogous to the R 2 index of the linear regression analysis.
  • ROC curves were employed to test the predictive value of all the variables included in the model with respect to implantation.
  • ROC curve analysis provides AUC values (area under the curve) that are comprised between 0.5 and 1 and can be interpreted as a measurement of the global classification ability of the model.
  • Statistical analysis was performed using the Statistical Package for the Social Sciences 17 (SPSS Inc., Chicago, IL) and MedCalc Software (Ghent, Belgium).
  • a total of 201 embryos gave successful implantation (gestational sac) out of the total 522 transferred, giving rise to a 38.5% implantation rate.
  • a single gestational sac was frequently observed after dual embryo transfer. As it was not possible to ascertain with certainty, which of the two transferred embryos that implanted, these embryos were excluded from further analysis. All embryos with known implantation were selected for further retrospective analysis. This analysis comprise 247 embryos; 61 with 100% implantation (number of gestational sacs matched with number of transferred embryos) and 186 with 0% implantation (no biochemical pregnancy was achieved).
  • Blastomeres are considered uneven sized if the average diameter of the large blastomere is more than 25% larger than the average diameter of the small blastomere. This definition implies that the volume of the large blastomere should be at least twice the volume of the small blastomere.
  • C) Multinucleation at the 4 cell stage during the interphase where the nuclei are visible (N 28) The embryo is considered multinucleated if more than one distinct nucleus is observed in one (or more) blastomeres,. From those 51 embryos only 4 implanted (8%) (two with uneven blastomere size and two that were multinucleated). Given the low implantation rate observed in the embryos showing these events it was suggested to use the listed observations as exclusion criteria for embryo selection as the frequency of implanting was very low (4 out of 51 i.e. 8%). Timing of embryo development events and implantation
  • Cleavage times for the first four divisions are shown in Figure 8 as percentages of embryos that have completed their cell division at different time-points after fertilization by ICSI.
  • the four blue curves represent the successive divisions of the 61 embryos, which implanted and the four red curves the 186 embryos that did not. It is apparent that there is a tighter distribution of cleavage times for implanting embryos as opposed to non-implanting embryos. A prominent tail of lagging embryos was found for the non- implanting embryos (red curves). At least for the late cleavages there also appeared a leading tail of too early cleaving embryos that were found not to implant. More detailed evaluation of the distribution of all divisional timings was performed.
  • FIG. 9 An example, the timing for cell division to five cells, t5, is shown in Figure 9.
  • the distribution of cleavage times for 61 implanting embryos (positive) are indicated by blue dots and for 186 non-implanting embryos (negative) by red dots.
  • the left panel show the overall distributions of cleavage times for the respective embryo types.
  • the right panel show the distribution of observed t5 cleavage times for the two embryos types plotted on a normal quantile plot. Observations following a normal distribution will fall along a straight line on this type of plot.
  • the cleavage time, t5 appears to follow a normal distribution for both types of embryos.
  • Example 2 data analysis based on known implantation data
  • KID known implantation data
  • the KID embryos are all transferred embryos with known implantation. With multiple embryos were transferred only total failure of implantation or total success is used. All multiple transfers with implantation that have less implanted embryos than transferred were discarded to enable the implantation success for the specific embryo.
  • the implantation success takes the value 1 if the transferred embryo led to successful implantation implanted and 0 if not.
  • the number of embryos (N) used for calculating the expected value (probability of success) of the target and non-target groups is different for different variables.
  • the data were divided into quartiles with respect to a single continuous variable (e.g. t2) and the expected value (probability of getting a success with one trial) of each quartile was calculated. From these quartile groups a new group was formed (the target group) either by the quartile with the highest expected value or by two or three neighboring quartiles having similar probability (see example in figure 13). A Fisher's exact test was used to test the hypothesis that the probability of implanting (expected value of the KID data) of embryos in the target group and outside the group was equal (Table 3). The hypothesis was rejected if the p-value was ⁇ 0.1 indicating that there was a difference between groups, and otherwise considered non-significant.
  • a single continuous variable e.g. t2
  • Table 4 Statistical evaluation of the probability of embryos implanting using discrete variables for all annotated embryos. The probability for implantation of the whole dataset was 0.28 with 1598 observations (N).
  • All the variables tested in table 4 can be used to exclude embryos with very low implantation rate since the implantation success rates of the embryos outside the target groups are 0.23 and below.
  • the two criteria cc2 ⁇ 5 h and cc3 ⁇ 5 h are associated with a low implantation success rate. This may be due to direct cleavage from 1 to 3 blastomeres and 2 to 5 blastomeres indicating a mismatch in DNA replication or in the cell division in general.
  • the embryos with these irregular division patterns will have asynchronous time-lapse data and may disturb any statistical calculation if they are included in the data.
  • the embryos with cc1 (t2) longer than 32 h are also associated with a low implantation success rate and are embryos that develop slowly, possibly due to immaturity of the oocytes.
  • Another option is to use composite variables calculated using the primary morpho- kinetic variables (timings and time periods). Especially interesting are variables that express the ratio between two morphological time periods. These types of normalized variables may hold information that is better for predictive models since they may take out some of the variability that may arise due to differences in temperature and other environmental variables and since they may be less sensitive to the definition of fertilization time. This could for example be cc2/cc2_3 and cc3/cc2_3 (the fraction of the first and second cell cycle out of the first two cell cycles) or s2/cc2 and s3/cc3 (the synchronicity of the first cell or second cell cycle relative to the time of the first or second cell cycle).
  • s3 t8-t5
  • s3a t6-t5
  • s3b t7-t6
  • s3c t8-t77
  • Possible irregularities or abnormalities in the mitosis may result in large differences between the value of s3a, s3b and/or s3c (i.e. one high max value).
  • Table 4 Quartile analysis of the composite variables, the target group, the implantation success rate (probability) for the embryos inside and outside the target groups, the number of observations in the target and non-target group and the p-value for Fisher's exact test.
  • Cc2/cc2_3 (t3-t2)/(t5-t2) Q2, Q3 0.42 - 0.47 0.32/0.25 779/779 0.002
  • ⁇ 3/cc2_3 (t5-t3)/(t5-t2) Q2, Q3 0.53 - 0.58 0.32/0.25 779/779 0.002
  • Early cleavage morphology affects the quality and implantation potential of day 3 embryos. Fertil Steril 2006;85:358-65. Cruz, M., Gadea, B., Garrido, N., Pedersen, K.S., Martinez, M., Perez-Cano, I., Munoz, M. and Meseguer, M. (201 1) "Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging" J Assist Reprod Genet, in press, Available online DOI 10.1007/s10815-01 1-9549-1
  • J Reprod Dev, vol. 55, pp. 328-331 Yamazaki, T., Yamagata, K. and Baba, T. (2007) "Time-lapse and retrospective analysis of DNA methylation in mouse preimplantation embryos by live cell imaging" Dev Biol, vol. 304, pp. 409-419
  • a method for determining embryo quality comprising monitoring the embryo for a time period, and determining one or more quality criteria for said embryo, and based on said one or more quality criteria determining the embryo quality.
  • the method according to item 1 wherein the embryo quality is determined from a plurality of said quality criteria, such as by combining a plurality of said quality criteria.
  • the quality criterion is a criterion relating to the phase of from 2 to 8 blastomere embryo, from 4 to 8 blastomere embryo.
  • the quality criterion is a criterion obtained within the time period of from 48 to 72 hours from fertilisation.
  • the embryo quality is a quality relating to implantation success.
  • a quality criterion is determination of the time for cleavage to a 2 blastomere embryo, a 3 blastomere embryo, a 4 blastomere embryo, a 5 blastomere embryo, a 6 blastomere embryo, a 7 blastomere embryo, and/or an 8 blastomere embryo.
  • the method according to any of the preceding items, wherein the quality criterion is selected from the group of normalized morphological embryo parameters.
  • the quality criterion is selected from the group of normalized morphological embryo parameters relating to the phase of from 2 to 8 blastomere embryo.
  • a quality criterion is a normalized morphological embryo parameter based on two, three, four, five or more parameters selected from the group of t2, t3, t4, t5, t6, t7 and t8.
  • a quality criterion is a normalized morphological embryo parameter based on four parameters selected from the group of t2, t3, t4, t5, t6, t7 and t8.
  • a quality criterion is based on the ratio of two time intervals, each of said time intervals determined as the duration of a time period between two morphological events in the embryo development.
  • said quality criterion is a normalized morphological embryo parameter.
  • said morphological events are selected from the group of fertilization, initiation of blastomere cleavage and completion of a blastomere cleavage.
  • cc2/cc3 (t3-t2)/(t5-t3).
  • the quality criterion is determination of t3/t5.
  • said quality criterion is an indicator of high embryo quality if t3/t5 is greater than 0.6, or greater than 0.62, or greater than 0.64, or greater than 0.66, or greater than 0.68, or greater than 0.7, or greater than 0.72, or greater than 0.74.
  • a quality criterion is determination of the extent of irregularity of the timing of cell divisions when the embryo develops from 4 to 8 blastomeres.
  • a quality criterion is determination of the maximum cleavage time for each blastomere when the embryo develops from 4 to 8 blastomeres.
  • said quality criterion is an indicator of high embryo quality if said maximum cleavage time is less than 1.5 hours.
  • said quality criterion is an indicator of high embryo quality if said maximum cleavage time is less than 2.5 hours, or less than 2.3 hours, or less than 2.1 hours, or less than 2 hours, or less than 1.9 hours, or less than 1.8 hours, or less than 1.7 hours, or less than 1.65 hours, or less than 1.6 hours, or less than 1.55 hours, or less than 1.5 hours, or less than
  • a quality criterion is determination of the ratio between the maximum cleavage time for each blastomere when the embryo develops from 4 to 8 blastomeres and the duration of the total time period from 4 to 8 blastomeres; max(s3a,s3b,s3c)/s3. .. .
  • said quality criterion is an indicator of high embryo quality if said ratio is less than 0.8, or less than 0.75, or less than 0.7, or less than 0.65, or less than 0.6, or less than 0.58, or less than 0.56, or less than 0.54, or less than 0.52, or less than 0.5, or less than 0.48, or less than 0.46, or less than 0.44, or less than 0.42, or less than 0.4.
  • a quality criterion is determination of the time for cleavage to a 5 blastomere embryo.
  • said quality criterion is an indicator of high embryo quality if t5 is greater than 46 hours, or greater than 47 hours, or greater than 47 hours, or greater than 48 hours, or greater than 48.5 hours, or greater than 48.7 hours, or greater than 48.9 hours, or greater than 49 hours, or greater than 49.1 hours, or greater than 49.2 hours, or greater than 49.3 hours, or greater than 49.4 hours, or greater than 49.5 hours, or greater than 49.6 hours, or greater than 49.7 hours, or greater than 49.8 hours, or greater than 49.9 hours, or greater than 50 hours, or greater than 51 hours, or greater than 52 hours, or greater than 53 hours.
  • said quality criterion is an indicator of high embryo quality if t8 is less than 60 hours, or less than 59 hours or less than 58 hours, or less than 57.8 hours, or less than 57.6 hours, or less than 57.4 hours, or less than 57.2 hours, or less than 57 hours, or less than 56.8 hours, or less than 56.6 hours, or less than 56.4 hours, or less than 56.2 hours, or less than 56 hours, or less than 55 hours.
  • a quality criterion is determination of the second cell cycle length cc2.
  • the method according to item 44, wherein said quality criterion is an indicator of high embryo quality if cc2b t4-t2 is less than 14 hours, or less than 13.9 hours, or less than 13.8 hours, or less than 13.7 hours, or less than 13.6 hours, or less than 13.5 hours, or less than 13.4 hours, or less than 13.3 hours, or less than 13.2 hours, or less than 13.1 hours, or less than 13 hours, or less than 12.9 hours, or less than 12.8 hours, or less than 12.7 hours, or less than 12.6 hours, or less than 12.5 hours, or less than 12.4 hours, or less than 12.3 hours, or less than 12.1 hours, or less than 12 hours, or less than 11.9 hours, or less than 11.9 hours, or less than 1 1.8 hours, or less than 11.7 hours, or less than
  • 29.2 hours or less than 29.1 hours, or less than 29 hours, or less than 28.9 hours, or less than 28.8 hours, or less than 28.7 hours, or less than 28.6 hours, or less than 28.5 hours, or less than 28.4 hours, or less than 28.2 hours, or less than 28 hours, or less than 27.5 hours, or less than 27 hours, or less than 26 hours.
  • criterion is a combination of determination of time for cleavage to a 5
  • the determination of embryo quality further includes i) determining the extent and/or spatial distribution of cellular or organelle movement during the cell cleavage period; and/or ii) determining the extent and/or spatial distribution of cellular or organelle movement during the inter-cleavage period thereby obtaining an embryo quality measure.
  • the embryo is monitored for a time period comprising at least three cell cycles, such as at least four cell cycles.
  • criterion includes information of blastomere evenness at t2, information of multi nuclearity at the two-blastomere stage and/or at the four-blastomere stage, and/or information of cleavage from one blastomere directly to three
  • blastomeres 67.
  • an exclusion criterion is that cc2 and/or cc3 is less than 10 hours, or less than 9.5 hours, or less than 9 hours, or less than 8.5 hours, or less than 8 hours, or less than 7.5 hours, or less than 7 hours, or less than 6.5 hours, or less than 6 hours, or less than 5.5 hours, or less than 5 hours, or less than 4.5 hours, or less than 4 hours, or less than 3.5 hours, or less than 3 hours, or less than 2.5 hours, or less than 2 hours, or less than 1.5 hours, or less than 1 hour.
  • an exclusion criterion is that t2 is greater than 28 hours, or greater than 28.5 hours, or greater than 29 hours, or greater than 29.5 hours, or greater than 30 hours, or greater than 30.5 hours, or greater than 31 hours, or greater than 31.25 hours, or greater than 31.5 hours, or greater than 31.75 hours, or greater than 32 hours, or greater than 32.5 hours, or greater than 33 hours, or greater than 33.5 hours, or greater than 34 hours.
  • an exclusion criterion is that cc2b is greater than 11 hours, or greater than 1 1.5 hours, or greater than 12 hours, or greater than 12.5 hours, or greater than 12.75 hours, or greater than 13 hours, or greater than 13.1 hours, or greater than 13.25 hours, or greater than 13.5 hours, or greater than 14 hours, or greater than 14.5 hours, or greater than 15 hours.
  • an exclusion criterion is that cc3 is greater than 15 hours, or greater than 15.5 hours, or greater than 16 hours, or greater than 16.5 hours, or greater than 17 hours, or greater than 17.25 hours, or greater than 17.5 hours, or greater than 17.6 hours, or greater than 17.75 hours, or greater than 18 hours, or greater than 18.5 hours, or greater than 19 hours, or greater than 19.5 hours.
  • an exclusion criterion is that s2 is greater than 1 hour, or greater than 1.1 hours, or greater than 1.2 hours, or greater than 1.3 hours, or greater than 1.4 hours, or greater than 1.5 hours, or greater than 1.6 hours, or greater than 1.7 hours, or greater than 1.8 hours, or greater than 1.9 hours, or greater than 2 hours, or greater than 2.1 hours, or greater than 2.2 hours, or greater than 2.3 hours, or greater than 2.4 hours, or greater than 2.5 hours, or greater than 2.6 hours, or greater than 2.7 hours, or greater than 2.8 hours, or greater than 2.9 hours, or greater than 3 hours.
  • an exclusion criterion is that s3 is greater than 2 hours, or greater than 2.2 hours, or greater than 2.4 hours, or greater than 2.6 hours, or greater than 2.8 hours, or greater than 3 hours, than 3.1 hours, or greater than 3.2 hours, or greater than 3.3 hours, or greater than 3.4 hours, or greater than 3.5 hours, or greater than 3.6 hours, or greater than 3.7 hours, or greater than 3.8 hours, or greater than 3.9 hours, or greater than 4 hours, than 4.1 hours, or greater than 4.2 hours, or greater than 4.3 hours, or greater than 4.4 hours, or greater than 4.5 hours, or greater than 4.6 hours, or greater than 4.7 hours, or greater than 4.8 hours, or greater than 4.9 hours, or greater than 5 hours, or greater than 5.25 hours, or greater than 5.5 hours, or greater than 6 hours.
  • a method for selecting an embryo suitable for transplantation comprising monitoring the embryo as defined in any of the items 1-74 obtaining an embryo quality measure, and selecting the embryo having the highest embryo quality measure.
  • a system for determining embryo quality comprising means for monitoring the embryo for a time period, said system further having means for determining a quality criteria for said embryo, and having means for determining the embryo quality based on said quality criteria.
  • the system according to item 76 comprising means for determining one or more of the features as defined in any of the items 1-74.

Abstract

La présente invention concerne un procédé et un système pour la sélection d'embryons pour la fécondation in vitro basés sur le timing, et la durée des clivages de cellules observés et de la morphologie des cellules associées. Une forme de réalisation de l'invention concerne un procédé pour la détermination de la qualité des embryons comprenant la surveillance de l'embryon pendant une période de temps, et la détermination d'un ou de plusieurs critères de qualité pour ledit embryon, ledit un ou lesdits plusieurs critères de qualité étant sur la mesure de l'irrégularité du timing des divisions cellulaires quand l'embryon se développe de quatre à huit blastomères, et/ou ledit un ou lesdits plusieurs critères de qualité étant basés sur la détermination du temps de clivage en un embryon à cinq blastomères (t5) et où t5 est entre 48,7 heures et 55,6 heures, et/ou ledit un ou lesdits plusieurs critères de qualité étant basés sur le rapport de deux intervalles de temps, chacun desdits deux intervalles de temps étant déterminé en tant que la durée d'une période de temps entre deux évènements morphologiques dans le développement de l'embryon à partir de la fécondation jusqu' a huit blastomères, et sur base desdits un ou plusieurs critères de qualité déterminant la qualité des embryons.
PCT/DK2012/050188 2011-05-31 2012-05-31 Evaluation de la qualité des embryons basée sur le clivage des blastomères et morphologie WO2012163363A1 (fr)

Priority Applications (9)

Application Number Priority Date Filing Date Title
EP12728169.9A EP2714895B1 (fr) 2011-05-31 2012-05-31 Evaluation de la qualité des embryons basée sur le clivage des blastomères et morphologie
CN201280035768.1A CN103748216B (zh) 2011-05-31 2012-05-31 基于卵裂球的卵裂和形态的胚胎质量评估
US14/122,335 US20140087415A1 (en) 2011-05-31 2012-05-31 Embryo quality assessment based on blastomere cleavage and morphology
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